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Related Concept Videos

Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
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Peripheral Artery Disease III: Interprofessional Care01:27

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Peripheral Artery Disease IV: Nursing Management01:26

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Methods for Acute and Subacute Murine Hindlimb Ischemia
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Arterial dissection during peripheral vascular interventions.

Fachreza Aryo Damara1, Dana Alameddine1, Martin Slade2

  • 1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT.

Journal of Vascular Surgery
|October 14, 2023
PubMed
Summary
This summary is machine-generated.

Arterial dissection (AD) occurred in 3% of peripheral vascular interventions (PVIs), increasing over time. This complication is linked to reduced primary patency and reintervention-free survival in patients with peripheral arterial disease.

Keywords:
Arterial dissectionPeripheral arterial diseasePeripheral vascular interventions

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Arterial Disease Management

Background:

  • Arterial dissection (AD) is a recognized complication of peripheral vascular interventions (PVIs).
  • The incidence and clinical significance of AD in peripheral arterial disease (PAD) treatment are not well-defined.
  • This study investigates AD within the Vascular Quality Initiative database.

Purpose of the Study:

  • To determine the incidence and trends of AD in patients undergoing PVIs for PAD.
  • To compare the characteristics and outcomes of patients with and without AD.
  • To assess the association of AD with primary patency and limb outcomes.

Main Methods:

  • Analysis of the Vascular Quality Initiative PVI registry (2016-2021).
  • Patients categorized based on the presence or absence of AD.
  • Comparison of patient demographics, disease characteristics, treatment modalities, and outcomes, with primary patency as the main endpoint.

Main Results:

  • AD occurred in 3% of 177,790 cases, with incidence rising from 2.4% to 3.6% (P=.007).
  • AD was more frequent in females and associated with femoropopliteal disease and complex lesions.
  • Patients with AD exhibited significantly lower primary patency (86.9% vs 91%) and reintervention-free survival (79.5% vs 84.1%) at 1 year.

Conclusions:

  • Arterial dissection is more prevalent in women and during femoropopliteal interventions.
  • AD is independently associated with decreased primary patency and reintervention-free survival following PVI for PAD.